Association of myocardial and liver T2* iron measurements with systolic and diastolic function by CMR feature tracking strain analysis

Background/ObjectivesMyocardial and liver iron overload can be assessed through T2* in magnetic resonance imaging (MRI). It is unclear, how T2* measurements are associated with systolic and diastolic left ventricular function assessed by novel feature tracking (FT) strain.MethodsConsecutive patients...

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Main Authors: Hugo G. Quezada-Pinedo, Benedikt Bernhard, Jan C. Zurkirchen, Anselm W. Stark, Noushin Sadat Ahanchi, Catherine Gebhard, Daniel Ott, Alan A. Peters, Hendrik von Tengg-Kobligk, Jonathan Schütze, Adam Bakula, Andreas Wahl, Kim N. Cajachagua-Torres, Taulant Muka, Christoph Gräni
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1547161/full
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author Hugo G. Quezada-Pinedo
Benedikt Bernhard
Jan C. Zurkirchen
Anselm W. Stark
Noushin Sadat Ahanchi
Noushin Sadat Ahanchi
Catherine Gebhard
Daniel Ott
Alan A. Peters
Hendrik von Tengg-Kobligk
Jonathan Schütze
Adam Bakula
Andreas Wahl
Kim N. Cajachagua-Torres
Taulant Muka
Christoph Gräni
author_facet Hugo G. Quezada-Pinedo
Benedikt Bernhard
Jan C. Zurkirchen
Anselm W. Stark
Noushin Sadat Ahanchi
Noushin Sadat Ahanchi
Catherine Gebhard
Daniel Ott
Alan A. Peters
Hendrik von Tengg-Kobligk
Jonathan Schütze
Adam Bakula
Andreas Wahl
Kim N. Cajachagua-Torres
Taulant Muka
Christoph Gräni
author_sort Hugo G. Quezada-Pinedo
collection DOAJ
description Background/ObjectivesMyocardial and liver iron overload can be assessed through T2* in magnetic resonance imaging (MRI). It is unclear, how T2* measurements are associated with systolic and diastolic left ventricular function assessed by novel feature tracking (FT) strain.MethodsConsecutive patients with suspected iron overload undergoing MRI T2* were retrospectively included. T2* was studied continuously and in categories: normal myocardial iron status (T2* ≥ 20 ms), myocardial iron overload (T2* < 20 ms), normal liver iron status (T2* ≥ 15.4 ms) and liver iron overload (T2* < 15.4 ms). Multivariable regression models were used to assess associations between T2* and FT strain.ResultsAmong 172 participants, longitudinal e/a ratio [−0.17 (−0.27, −0.08), p = 0.001], longitudinal early diastolic strain rate [−0.13 (−0.23, −0.03), p = 0.014], circumferential late diastolic strain rate [0.18 (0.03, 0.32), p = 0.016], longitudinal late diastolic strain rate [0.20 (0.03, 0.36), p = 0.019] were associated with higher T2*. Liver iron overload was associated with circumferential systolic strain rate [−0.42 (−0.74, −0.09), p = 0.014] and longitudinal early diastolic strain rate [0.27 (0.04, 0.49), p = 0.023]. Combined liver and myocardial iron overload were associated with longitudinal e/a ratio [0.72 (0.19, 1.24), p = 0.008]. No associations of T2* values with systolic function were found.ConclusionLiver and a combination of myocardial and liver iron overload were associated with increased early diastolic filling and increased e/a ratio respectively, which may serve as markers of diastolic dysfunction. Impaired diastolic function, even in the absence of myocardial iron overload was associated with liver iron metabolism and may indicate early cardiac involvement, while left ventricular systolic function is still preserved.
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spelling doaj-art-94c885331d1a49b0b84d99c204f6b5e72025-08-20T03:02:28ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-03-011210.3389/fcvm.2025.15471611547161Association of myocardial and liver T2* iron measurements with systolic and diastolic function by CMR feature tracking strain analysisHugo G. Quezada-Pinedo0Benedikt Bernhard1Jan C. Zurkirchen2Anselm W. Stark3Noushin Sadat Ahanchi4Noushin Sadat Ahanchi5Catherine Gebhard6Daniel Ott7Alan A. Peters8Hendrik von Tengg-Kobligk9Jonathan Schütze10Adam Bakula11Andreas Wahl12Kim N. Cajachagua-Torres13Taulant Muka14Christoph Gräni15Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United StatesDepartment of Cardiology, Bern University Hospital, University of Bern, Bern, SwitzerlandDepartment of Cardiology, Bern University Hospital, University of Bern, Bern, SwitzerlandDepartment of Cardiology, Bern University Hospital, University of Bern, Bern, SwitzerlandInstitute of Social and Preventive Medicine (ISPM), Graduate School of Health Sciences, University of Bern, Bern, SwitzerlandGraduate School for Health Sciences, University of Bern, Bern, SwitzerlandDepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC, United StatesDepartment of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, SwitzerlandDepartment of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, SwitzerlandDepartment of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, SwitzerlandDepartment of Cardiology, Bern University Hospital, University of Bern, Bern, SwitzerlandDepartment of Cardiology, Bern University Hospital, University of Bern, Bern, SwitzerlandDepartment of Cardiology, Bern University Hospital, University of Bern, Bern, SwitzerlandDepartment of Pediatrics, New York University Grossman of Medicine, New York University, New York, NY, United StatesEpistudia, Bern, SwitzerlandDepartment of Cardiology, Bern University Hospital, University of Bern, Bern, SwitzerlandBackground/ObjectivesMyocardial and liver iron overload can be assessed through T2* in magnetic resonance imaging (MRI). It is unclear, how T2* measurements are associated with systolic and diastolic left ventricular function assessed by novel feature tracking (FT) strain.MethodsConsecutive patients with suspected iron overload undergoing MRI T2* were retrospectively included. T2* was studied continuously and in categories: normal myocardial iron status (T2* ≥ 20 ms), myocardial iron overload (T2* < 20 ms), normal liver iron status (T2* ≥ 15.4 ms) and liver iron overload (T2* < 15.4 ms). Multivariable regression models were used to assess associations between T2* and FT strain.ResultsAmong 172 participants, longitudinal e/a ratio [−0.17 (−0.27, −0.08), p = 0.001], longitudinal early diastolic strain rate [−0.13 (−0.23, −0.03), p = 0.014], circumferential late diastolic strain rate [0.18 (0.03, 0.32), p = 0.016], longitudinal late diastolic strain rate [0.20 (0.03, 0.36), p = 0.019] were associated with higher T2*. Liver iron overload was associated with circumferential systolic strain rate [−0.42 (−0.74, −0.09), p = 0.014] and longitudinal early diastolic strain rate [0.27 (0.04, 0.49), p = 0.023]. Combined liver and myocardial iron overload were associated with longitudinal e/a ratio [0.72 (0.19, 1.24), p = 0.008]. No associations of T2* values with systolic function were found.ConclusionLiver and a combination of myocardial and liver iron overload were associated with increased early diastolic filling and increased e/a ratio respectively, which may serve as markers of diastolic dysfunction. Impaired diastolic function, even in the absence of myocardial iron overload was associated with liver iron metabolism and may indicate early cardiac involvement, while left ventricular systolic function is still preserved.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1547161/fullT2*iron overloadretrospective studiesfeature trackingstraindiastolic function
spellingShingle Hugo G. Quezada-Pinedo
Benedikt Bernhard
Jan C. Zurkirchen
Anselm W. Stark
Noushin Sadat Ahanchi
Noushin Sadat Ahanchi
Catherine Gebhard
Daniel Ott
Alan A. Peters
Hendrik von Tengg-Kobligk
Jonathan Schütze
Adam Bakula
Andreas Wahl
Kim N. Cajachagua-Torres
Taulant Muka
Christoph Gräni
Association of myocardial and liver T2* iron measurements with systolic and diastolic function by CMR feature tracking strain analysis
Frontiers in Cardiovascular Medicine
T2*
iron overload
retrospective studies
feature tracking
strain
diastolic function
title Association of myocardial and liver T2* iron measurements with systolic and diastolic function by CMR feature tracking strain analysis
title_full Association of myocardial and liver T2* iron measurements with systolic and diastolic function by CMR feature tracking strain analysis
title_fullStr Association of myocardial and liver T2* iron measurements with systolic and diastolic function by CMR feature tracking strain analysis
title_full_unstemmed Association of myocardial and liver T2* iron measurements with systolic and diastolic function by CMR feature tracking strain analysis
title_short Association of myocardial and liver T2* iron measurements with systolic and diastolic function by CMR feature tracking strain analysis
title_sort association of myocardial and liver t2 iron measurements with systolic and diastolic function by cmr feature tracking strain analysis
topic T2*
iron overload
retrospective studies
feature tracking
strain
diastolic function
url https://www.frontiersin.org/articles/10.3389/fcvm.2025.1547161/full
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